Migraine -- Adult

Definition

Migraine is a type of recurring headache. It involves nerves and brain chemicals. Other sensations, such as auras, may come before a migraine headache.

There are 2 types of migraines:

Occurring with an aura—formerly called a classic migraine

Occurring without an aura—formerly called a common migraine

Migraine may happen several times a week or once every couple of years. They can be so severe that they interfere with the ability to work and carry on normal activities.

Causes

While the precise cause is not known, many potential triggers have been identified. Common triggers include:

Environmental triggers, such as odors and bright lights

Dietary triggers, such as alcohol

Certain medications

Changes in sleep patterns

Stress

Physiologic changes, such as menstruation and puberty

Weather changes

A trigger sets the process in motion. It is possible that the nervous system reacts to the trigger by conducting electrical activity. This spreads across the brain. It leads to the release of brain chemicals, which help regulate pain.

Risk Factors

Migraines are more common in women, especially before the age of 40. Other factors that increase your risk for migraines may include:

Family history of migraines

Menstruation

Obesity

Presence of patent foramen ovale—a congenital heart defect

Symptoms

Migraines occur in phases that may include:

Warning

A warning may come before a migraine. In the hours or days before the headache, symptoms may include:

Treatment

Medications

Pain medications
are often needed to ease or stop the pain. Over-the-counter pain pills may ease mild symptoms.

Some pain relievers have caffeine as an ingredient, since it may help improve pain relief. If yours does not, talk to your doctor about taking a caffeine supplement with your pain reliever.

Warning:
Regular use of some over-the-counter medications may cause a rebound headache.

Some prescription medications act directly to stop the cause of the migraine headache. These include drugs that:

Quiet nerve pathways

Reduce inflammation

Bind receptors for serotonin, a brain chemical

These drugs can be taken by mouth. They may act more quickly in forms that dissolve in the mouth, are inhaled through the nose, or injected. They are more likely to be helpful if taken as soon as possible at the start of a migraine. Your doctor can help you choose the medication best for you.

Medications that can help stop a migraine once it has begun include:

Triptans

Steroids

Acetaminophen

Non-steroidal anti-inflammatory drugs (NSAIDS)

Medications for nausea

Ergots

Combination medication that contains caffeine

Other drugs can help prevent migraines for people with frequent migraines. Preventive drugs are taken every day. Classes of preventive medications include:

Therapy

Therapy may also be used to reduce the length and frequency of migraine headaches. It may be used with or without medication and may include cognitive behavioral therapy, biofeedback, or relaxation methods.

Procedures

Botulinum Toxin Injections

Botulinum toxin injections
may be used as a way to prevent migraines and to reduce the duration and intensity of the headaches in people who have headaches often.

Surgery

In some people, migraines are triggered when a nerve in the head is stimulated. With this type of surgery, the nerve trigger point is located in the head and is deactivated. This surgery may reduce the number of migraines or completely eliminate them in sufferers who do not respond to conventional treatments. Most migraines are not treated with surgery.

Transcranial magnetic stimulation surgery may also be used in patients with migraine with aura who have not responded to other treatments.

Self-Care During the Migraine

Apply cold compresses to painful areas of your head.

Lie in a dark, quiet room.

Try to fall asleep.

Lifestyle Changes

Keep a diary. It will help identify what triggers your migraines and what helps relieve them.

Learn stress management and relaxation techniques.

Consider talking with a counselor to learn new coping skills and relaxation techniques.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.